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Support@MyersInk.net

​BILOXI ~ (228) 396-5185

OCEAN SPRINGS ~ (228) 872-4444

GULFPORT ~ (228) 575-4488

Our clinics with optical shops

LASIK      Contact Lenses      Eyeglasses      Sunglasses

Cataract Lens Implants      Sports Goggles      Swimming Goggles

​​Choose sharp vision on the beautiful Gulf Coast!

​​Choose sharp vision on the beautiful Gulf Coast!

Eye Associates of the South / (228) 396-5185

Patients@2020view.com

Insurance &

Policy Forms

  • PATIENT BASIC FORM
  • ​PERSONAL INFORMATION FORM
  • ​MEDICAL HISTORY FORM
  • ​EYE HISTORY FORM

All patients need to fill out these patient forms, either at our clinic before your appointment or at least 24 hours in advance online here. (A third option is to print out the pdf of forms at the top of this website page, then bring those printed, filled-out pages to your appointment.) We appreciate those who fill them out in advance. Plus, it means you'll need to spend less time at your appointment.


FILL OUT ALL 8 ONLINE PATIENT FORMS IF YOU HAVE INSURANCE, INCLUDING WITH OR WITHOUT VISION COVERAGE. FILL OUT 6 FORMS (* ALL BUT THE 2 FORMS NAMED INSURANCE) IF YOU DO NOT HAVE INSURANCE.


​Please arrive at your appointment 20 minutes early if you have not filled out these forms yet. Otherwise, please arrive 10 minutes early.


This is a secure website, so you may fill out our forms online with confidence!​ Moreover, our online forms will not ask for your social security number. We will add that information when you arrive for your appointment.


Bring any insurance, Medicare and/or Medicaid card(s) with you.

Medical &

History Forms


  • ​HIPAA FORM
  • NO-SHOW POLICY FORM
  • INSURANCE FORM *
  • ​INSURANCE OPTIONS FORM *

Forms​​

MAIN PAGE

WE ACCEPT MOST INSURANCE AS WELL AS MEDICARE & MEDICAID.

WEBSITE CONSTRUCTION NOTE: We are in the process of creating electronic forms for patients to fill out before their appointments. Patients' electronic forms are not ready for patients to use yet. BUT you may download and print out all of our patient forms by clicking on the button above, print out the downloaded pdf, fill out the pages by hand, and bring all completed pages to your appointment. If you don't have time to complete the forms in advance, we will give you the forms to fill out during your appointment. Thank you!

CareCredit offers money options

SEE CareCredit INFO

AT​ BOTTOM OF PAGE

CareCredit offers financial credit to qualifying patients to pay for eye exams, eyeglasses, LASIK, cataract surgery and certain other eye care services.


Patients of Eye Associates of the South may receive credit terms of 0% (0 percent)​​ interest on up to $2,000 credit, with up to 2 years to pay for our included optical goods and services.


Ask us about it or contact CareCredit.

For your convenience, pay the balance of your bill (if any) here online, after your appointment.


If you cannot afford to pay the balance, pay as much as you are able, then call our main Biloxi clinic at (228) 396-5185 to set up a payment plan.


(First payments and insurance co-payments are collected during your appointment.  But additional costs sometimes are due.) Payments by check also may be mailed to:

Eye Associates of the South​

1720A Medical Park Drive, Suite 330

Biloxi, MS   39532


This is a secure website, so you may pay online with confidence!

Online

Payment Forms

Forms